Risk Factors of Healthcare-associated Infections Among Pediatric Hospitalized Patients in Chinese General Hospitals From 2001 to 2020: A Systematic Review and Meta-Analysis

Abstract

Background: Healthcare-associated infections (HAIs) have been an increasing global public health threat to the globe. Paediatric hospitalized patients are particularly to HAIs and the identification of risk factors is essential to help policy-makers and hospital managers to develop prevention and control strategies. This study aims to determine the risk factors associated with HAIs among paediatric hospitalized patients in Chinese general hospitals.Methods: Medline, EMBASE and Chinese Journals Online databases were searched. The search was limited to studies published from January 1st 2001 and December 31st 2020. Meta-analyses of OR in the prevalence were estimated. Heterogeneity between studies was assessed based on the B2 and I2 statistics to select the meta-analysis model. Reviewer Manager 5.3 was employed and P<0.05 was considered as the statistical significance.Results: 205 published articled were searched from the databases, in which 25 studies were included in the quantitative synthesis and meta-analysis for the risk factors of HAIs among paediatric hospitalized patients in Chinese general hospitals. 61,773 paediatric patients were incorporated in the included studies, which covered 13 regions in 10 provinces in China. Of them, 2,438 paediatric patients had HAIs. The meta-analyses showed that the ORs of younger age(2.25[1.32-3.85]), hormone(3.66[1.73-7.74]), invasive procedures(5.62[4.27-7.40]), longer hospitalization stay (7.79[6.38-9.50]), malnutrition(3.72,[1.80-7.70]), over 3 kinds of antibiotics (3.25,[2.66-3.96]), over 3 kinds of underlying disease (4.24[1.84-9.78]), large room (2.22[1.28-3.85)), and autumns and winter (1.56[1.04-2.35)) were the independent risk factors that had a negative impact on HAIs with a statistical significance (P<0.05).Conclusions: Under the age of 1 year, application of hormone, experiencing invasive procedure, hospitalization stay more than 7 days, malnutrition, using more than 3 kinds of antibiotics, beyond 3 kinds of underlying disease, large room, and autumn and winter were the main risk factors associated with the higher prevalence of HAIs among paediatric hospitalized patients in Chinese general hospitals. This provided the evidence base to inform the policy-makers and hospital managers. The confirmed successful and cost-effective prevention and control measures need to be adopted to reduce the occurrence of HAIs.

Prevalence of nosocomial infection and associated factors among paediatric patients admitted to Jimma medical center, Oromia region, southwest Ethiopia. Cross-Sectional Study

“…The data collection tools were adapted after a review of different relevant literature (25)(26)(27)29,(33)(34)(35). The tools were prepared in the English language.…”